02170nas a2200301   4500000000100000008004100001260006800042653000900110653002600119653001100145653002500156653000900181653002500190653001200215100001700227700001700244700001300261700001500274700001500289700001800304700001400322700001500336245009200351300001100443490000700454520139300461022001401854       2012                            d  c2012 FebbPhysicians Continuing Education CorporationaNew York10aAged10aAnti-Bacterial Agents10aHumans10aLeprosy, lepromatous10aMale10aMycobacterium leprae10aOntario1 aJessamine PG1 aDesjardins M1 aGillis T1 aScollard D1 aJamieson F1 aBroukhanski G1 aChedore P1 aMcCarthy A00aLeprosy-like illness in a patient with Mycobacterium lepromatosis from Ontario, Canada.  a229-330 v113 a<p>Here we present the first case of a patient from Ottawa Canada, presenting with leprosy-like illness associated with Mycobacterium lepromatosis. The patient had no history of travel to leprosy-endemic areas or any obvious risk factors. Clinically, the patient presented with an anesthetic maculopapular rash on the trunk, back, and extremities. A skin biopsy of a lesion revealed a dermal lymphohistiocytic infiltration involving the vessels with an inflammatory process extending to the nerves. A neurological exam also identified a severe sensorimotor polyneuropathy. Concurrently, the patient was diagnosed with non-resectable, non small cell carcinoma of the lung, further complicating his clinical presentation. A Kinyoun stain of nasal blows and a Fite stain of the skin biopsy revealed few to moderate acid fast bacilli respectively. Cultures of the skin biopsy and multiple nasal blows were negative. Molecular studies of a skin biopsy sample including sequence analysis of a 765 bp region of the 16s rRNA gene eventually identified the organism with 100% homology to M. lepromatosis. The patient was treated for leprosy and appeared to improve slightly on therapy but died as a result of his malignancy approximately five months after the initiation of therapy. This represents the first case of a patient with M. lepromatosis like illness outside of Mexico and Singapore.</p>  a1545-9616